ABSTRACT
BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is the most common type of malignant lymphoma (ML), accounting for 30%-40% of cases of non-Hodgkin's lymphoma (NHL) in adults. Primary paranasal sinus lymphoma is a rare presentation of extranodal NHL that accounts for only 0.17% of all lymphomas. ML from the maxillary sinus (MS) is a particularly rare presentation, and is thus often difficult to diagnose. We have reported the first known case of DLBCL originating from the MS with rapidly occurrent multiple skin metastasis. CASE SUMMARY: An 81-year-old Japanese man visited our hospital due to continuous pain for 12 d in the left maxillary nerve area. His medical history included splenectomy due to a traffic injury, an old right cerebral infarction from when he was 74-years-old, hypertension, and type 2 diabetes mellitus. A plain head computed tomography (CT) scan revealed a 3 cm × 3.1 cm × 3 cm sized left MS. On day 25, left diplopia and ptosis occurred, and a follow-up CT on day 31 revealed the growth of the left MS mass. Based on an MS biopsy on day 50, we established a definitive diagnosis of DLBCL, non-germinal center B-cell-like originating from the left MS. The patient was admitted on day 62 due to rapid deterioration of his condition, and a plain CT scan revealed the further growth of the left MS mass, as well as multiple systemic metastasis, including of the skin. A skin biopsy on day 70 was found to be the same as that of the left MS mass. We notified the patient and his family of the disease, and they opted for palliative care, considering on his condition and age. The patient died on day 80. CONCLUSION: This case suggests the need for careful, detailed examination, and for careful follow-up, when encountering patients presenting with a mass.
ABSTRACT
BACKGROUND: Neurogenic pulmonary edema is a rare but serious complication of febrile status epilepticus in children. Comprehensive screening for viral pathogens is seldomly performed in the work-up of febrile children. CASE PRESENTATION: A 22-month-old girl presented with her first episode of febrile status epilepticus, after which she developed acute pulmonary edema and respiratory failure. After the termination of seizure activity, the patient was intubated and managed on mechanical ventilation in the emergency room. The resolution of respiratory failure, as well as the neurological recovery, was achieved 9 h after admission, and the patient was discharged 6 days after admission without any complications. Molecular biological diagnostic methods identified the presence of human coronavirus HKU1, influenza C virus, and human parainfluenza virus 2 from the patient's nasopharyngeal specimens. CONCLUSIONS: Neurogenic pulmonary edema following febrile status epilepticus was suspected to be the etiology of our patient's acute pulmonary edema and respiratory failure. Timely seizure termination and rapid airway and respiratory intervention resulted in favorable outcomes of the patient. Molecular biological diagnostic methods identified three respiratory viruses; however, their relevance and association with clinical symptoms remain speculative.
Subject(s)
Pulmonary Edema/etiology , Respiratory Tract Infections/virology , Central Nervous System Diseases/etiology , Central Nervous System Diseases/therapy , Coronavirus/isolation & purification , Coronavirus Infections , Female , Fever/complications , Humans , Infant , Influenza, Human , Gammainfluenzavirus/isolation & purification , Molecular Diagnostic Techniques , Nasopharynx/virology , Parainfluenza Virus 2, Human/isolation & purification , Pulmonary Edema/diagnostic imaging , Pulmonary Edema/therapy , Respiratory Tract Infections/complications , Status EpilepticusABSTRACT
Ethyl alpha-D-glucoside (alpha-EG) is a peculiar component in sake, a traditional Japanese alcoholic beverage. In this study, morphological changes in kidney and effects on urine excretion by alpha-EG ingestion were investigated. After the rats were fed with pellet diets containing 100% or 20% alpha-EG dietary level, alpha-EG was detected in urine and urine volume showed significant increase (p<0.05). Kidney weights were increased (p<0.05) and renal tubules were dilated in the rats by alpha-EG ingestion, whereas there was no detectable histopathological damage to renal cells. Plasma uric acid and urea levels were not affected. In conclusion, ingested alpha-EG was excreted in urine, increasing urine volume. Increase in kidney weight related to renal tubule dilation was observed with alpha-EG ingestion without deteriorate changes in the renal cells or functions.
